The effect of a self-care minimal intervention for colds and flu on the use of medical services.

Abstract

OBJECTIVE: To determine the impact of mailed distribution of a brief self-care pamphlet on upper respiratory infection (URI)-related-medical care utilization. DESIGN: Randomized controlled clinical trial with randomization by physician panel. SETTING: Health maintenance organization. PATIENTS: 20,127 patients assigned to the panels of 22 primary care physicians randomly divided into an experimental group (n = 12,353) and a control group (n = 7,774), each consisting of 11 physician panels. INTERVENTION: A mailed four-page self-care pamphlet for URI care. MEASUREMENTS AND MAIN RESULTS: The medical records and survey data of a random sample of 790 persons were studied during a baseline period and an intervention period. URI visit rates decreased 14% more in the experimental group versus the control group (p = 0.878). Appropriateness of URI visits during the intervention period in the experimental group (80%) was comparable to that in the control group (76%). URI drug prescriptions during the intervention period for all 20,127 patients showed no significant difference. CONCLUSIONS: A simple mailed self-care pamphlet has little effect on medical care utilization for URI care.